Feasibility of cervical dorsal rami nerve block in posterior approach of cervical vertebra operation
- VernacularTitle:颈神经后支阻滞麻醉用于颈椎后路手术的可行性研究
- Author:
Shaohua MIAO
;
Yanxue DAI
;
Haifeng WANG
- Publication Type:Journal Article
- Keywords:
Feasibility studies;
Cervical vertebra surgery,posterior approach;
Cervical dorsal rami nerve,block anesthesia
- From:
Chinese Journal of Postgraduates of Medicine
2008;31(30):12-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective To probe the validity and security of cervical dorsal rand nerve block in posterior approach of cervical vertebra surgery.Methods Eighty-six adults ASA class I-II patients undergohag posterior approach of cervical spine operation randomized equally to cervical dorsal rami nerve block group (group I )and partial infiltration anesthesia group (group II ).In group I ,according to regional anatomy characteristic of the nerve and by means of preopomtively measuring the cervical vertebra X -ray,the body surface projection of articular process joint waist of cervical vertebra were calibrated.Away 3 cm from latter median line,percutaneous puncture via 45° angle relative into sagittal plane ,adopting long 8 cm 7# needle and anesthetic to block ~e surgical incision corresponding bilateral dorsal rami nerves.In group II,using traditional local infiltration anesthesia.The effect and response time of anesthesia,influence on breathing and hemodynamics or pulse oxygen saturation,visual analogue score( VAS ) and calmed grade postoperatively and adverse reaction were observed and recorded.Results The anesthesia excellent rate (74%) in group I was obviously higher than that(42%) in group II (P < 0.05 ).The surgeries average time in group I was less than that in group II,but no statistical significance (P> 0.05).The average dose of anesthetic in group I was obviously lower than that in group II (P < 0.01 ).The mean arterial pressure elevated after anesthesia in both groups,and in group I was significantly lower than that in group lI (P < 0.05 ).The SpO2 of both > 95%.Calmed grade and VAS at 24 and 48 h postoperatively were significantly lower in group I than that in group II (P< 0.05).There was no adverse reactions.Conclusions Compared to other anesthesia methods in posterior approach of cervical vertebra surgery,the method of cervical dorsal rami nerve block has so undermentioned dominances: simple,less anesthetic,exact effect of anesthesia,light influence on breathing and hemeodynamies and lower injury of spinal cord or spinal nerve root that the method is safe and feasible.